Case 4

Name: Mrs. M N                                                            Age: 63 years

Sex: Female                                                                  Date of visit: 2-3-1995

Chief complaints:

There is dim vision in the Rt. Eye since January 1992. She had redness of the eye followed by gradual loss of the vision.

She can see only from the left eye.

She was treated with local and systemic steroids without any improvement and was then referred for homoeopathic treatment.

She also has cough with yellowish expectoration since three years which is    < winter, < afternoon (after eating). She has been started on Tab. Isonex by her doctor for the cough (TB).

Life Situation and Mind:

Mild personality.

Very fearful. Fear of darkness³. Fear of being alone³. She has a fear of ghosts and feels that ghosts might creep out of the dark areas of the house.

Hence she wants company, especially at night.

Sleep:

Poor. Scared at night. Gets sleep at 2-3 am.

Patient as a Person:

Appetite: OK

Desires: Spicy³

Aversion: –

Thirst: Increased. Wants cold water.

Sweat: normal

Stools: Takes Isabgul (husk preparation) to get proper bowel movements.

Urine: D:N::4:2-3

Chilly patient

Past History:

Nothing particular

Family History:

Nothing particular

Examination findings: (S/B Dr. Maniar on 28-2-1995)

Vision: Rt. Eye- F.C. upto 2 feet

Fundus: Ant. vitreous haze with vitreous floaters

Investigations: Blood sugar: (F)-82, (PP)- 92; Mantoux test: – ve

Diagnosis: Rt. Eye vitreitis

Treatment: Phos 200 tds x 7 days

Follow up:

10-03-1995: No redness of eye. Dimness of vision >.

Treatment- ct all x 7 days.

17-03-1995: (S/B Dr. Maniar: Vision – 6/60; Fundus- ant. haze +, floaters +)

Treatment- ct all x 7 days.

24-03-1995: Vision improved.

Treatment- SL tds x 14 days

10-04-1995: (S/B Dr. Maniar: Vision – 6/36; Fundus- ant. haze +, floaters +)

Treatment- ct all x 14 days.

24-04-1995: Haziness of vision >. Can see objects clearly. Floaters >.

Treatment- ct all x 14 days.

08-05-1995: Vision again dim since 3 days. Floaters +.

Treatment- Phos 200 tds x 7 days, then SL tds x 7 days.

23-05-1995: Vision improved once again. Haziness > ++; Floaters > +

Treatment- ct all x 14 days.

05-06-1995: (S/B Dr. Maniar: Vision – 6/9; Fundus- clear, floaters- nil)

Treatment- SL tds x 14 days.

05-07-1995: (S/B Dr. Maniar: Vision – 6/9; Fundus- clear, floaters- nil; IOP-

normal). Treatment- SL tds x 14 days.

Name: Mr. N V                                                             Age: 60 years

Sex: Male                                                                     Date of visit: 23-5-1996

Chief complaints:

The patient developed sudden black spots in the Rt. Eye in front of his vision about 2 months ago. Blurring of vision and ultimately complete loss of vision followed this. He cannot make out details of the objects. There is also a stiffness of the Rt. Eye in the morning on waking. He is a welder by profession and is exposed to very bright light.

He also complains of gases and flatulent distension of the lower abdomen, which is < eating pulses and > passing flatus.

Life Situation and Mind:

He is married and has 3 sons and 2 daughters.

He joined a religious group 24 years ago and since then he has stopped eating non-vegetarian food and now helps in the local temple.

He has been working as a welder for the past 40 years but is not treated well by his boss.

He is mild and does not retaliate if insulted, though he feels hurt and sometimes gets a desire to hit the other person. He will weep if insulted.

No tensions or fears.

Patient as a Person:

Skin: Vitiligo on hands and feet

Appetite: Poor

Desires: Sweets³, Salt, Milk

Aversion: Spicy

Thirst: Increased. Mixes fridge and pot water

Sweat: Profuse, no stains/ odours

Stools: Daily but hard and unsatisfactory

Urine: D:N::4-5:2-3. No straining

Past History:

Rt. Herniorrhaphy, Rt. Hydrocele (RCTVH done)

Family History:

Nothing significant

Examination findings:

Rt. Eye: Vitreous haze ++, Vision- FC (finger counting), IOP- Normal

Investigations: (7-5-1990)

Blood Sugar: (F)- 93 mg%; (PP)-127 mg%

RBC- 4.3, Hb- 13, TC- 12,200, N/60, L/24, E/6; ESR- 15mm

Diagnosis: Rt. vitreitis

Treatment: Lyco 200 tds x 7 days

Follow up:

28-05-1996: Vision SQ. Treatment- ct all x 7 days.

04-06-1996: Vision- can detect light; flatulent distension >.

Treatment- ct all x 7 days.

12-04-1996: Vision improving, no gases. Treatment- SL tds x 14 days.

26-04-1996: (S/B Dr. Maniar: Vision- Rt. Eye- 6/60, IOP- normal.)

Pt. complains of smoky vision; but can appreciate shapes.

Treatment- ct all x 14 days.

11-05-1996: Vision- slightly better. Gases again +

Treatment- Lyco 200 tds x 7 days then SL tds x 7 days.

25-05-1996: (S/B Dr. Maniar: Vision- 6/24, Media clearer, Very few floaters

seen, IOP- normal.) Symptomatically  >

Treatment- SL tds x 14 days.

11-06-1996: Vision improved. Can read letters on TV clearly. Haziness of

vision reduced ++. Gases and abdominal distension >

Treatment- ct all x 14 days.

26-06-1996: (S/B Dr. Maniar: Vision- 6/12, Media clear, floaters reduced

IOP- normal.) Pt. again complains of gases and distension of the

lower abdomen after eating pulses. Vision is better and haziness

has reduced almost completely.

Treatment- Lyco 200 tds x 7 days then SL tds x 7 days.

26-07-1996: Vision improved. No haziness of vision. No gases. (S/B Dr.

Maniar: Vision- 6/9, Media clear, floaters nil, IOP- normal. Has

recommended new glasses.) Treatment- SL tds x 1 month.

Name: Mrs. K M                                                            Age: 58 years

Sex: Female                                                                  Date of visit: 3-6-1994

Chief complaints:

This patient had a Rt. Cataract surgery on 8-4-1994 and developed a blurring of vision after that. She was diagnosed as suffering from Vitreitis of the Rt. Eye and treated with local steroid and atropine drops. She was also given a retro bulbar injection of steroids.

Since she was not responding well to this treatment, she was referred for homoeopathic treatment.

Life Situation and Mind:

She has been irritable recently. She has a weeping tendency. She likes company.

Patient as a Person:

Appetite: Reduced since 1 month

Desires: Spicy³

Aversion: nothing particular

Thirst: Increased. Drinks extremely cold water

Tongue: clean

Sweat: in summer. Stains yellow. Odour +

Stools: 2 /day

Urine: D:N::3-4:0

Chilly patient

Gyn. & Obst. History: Menopausal since 11 years

Past History: nothing particular

Family History: nothing particular

Examination findings:

Rt. Eye- vision: finger counting; vitreous haze ++

Treatment: Arnica 200 tds x 14 days

Follow up:

17-06-1994: Vision still blurred. Treatment- Phos 200 tds x 14 days followed

by SL tds x 7 days.

14-07-1994: Vision improved from FC to 6/12 with glasses. Pain Rt. Eye.

Photophobia. S/B Dr. Maniar: Congestion ++. Rt. Sup. Temporal

branch arterial occlusion. Treatment- Bell 200 tds x 14 days.

03-08-1994: Vision OK. Objects appear larger. Occasional chest pain that

lasts for a few minutes. S/B Dr. Maniar: Fundus- Vitreitis +, Rt.

Eye- 6/24, IP- normal. Treatment- Phos 200 tds x 14 days.

05-09-1994: (S/B Dr. Maniar on 1-9-1994: Vision- 6/12; Fundus- clear; IOP-

normal.) Retrosternal burning, 1-2 hours after eating. Pain in the

eye since 2 days. Treatment- SL tds x 14 days.

26-10-1994: (S/B Dr. Maniar on 18-10-1994: Rt. Eye- no ciliary flush; Vision-

6/12; Fundus- clear; IOP- normal.) Presently complains of pain in

the eye. Retrosternal burning < after eating.

Treatment- Phos 1M (I) dose and SL tds x 14 days.

Arnica is the drug that I frequently use to begin the treatment of uveitis caused by trauma. In most of the cases, the trauma is surgery on the eye for cataract. In spite of the fact that surgical trauma is more of an incision (clean cut wounds) and is not due to blunt injuries, Arnica is very useful.

In Allen’s Keynotes, the first line of the ‘eye remedy’, Euphrasia reads “Bad   effects from falls, contusions or mechanical injuries of external parts [Arn.]” However, when I gave Euphrasia to many of the patients who had earlier come with the history of cataract surgery or other trauma to the eye, it did not bring about any positive change. Hence, Arnica was next given to the patients- with wonderful results. I have found that in uncomplicated cases (patients with no other constitutional symptoms), Arnica is the sole remedy to treat the inflammation and restore the vision.

There is not much scope for the use of rare remedies in the treatment of uveitis, mainly because it is a result of some immune mechanism and needs internal constitutional treatment.

Many of the patients with vision of only Finger Counting (FC) before treatment have had their sight restored after giving the indicated homoeopathic medicine and the acuity of vision in such cases has improved to 6/12 and even 6/9.

Most of the other patients have had their vision restored to 6/9 or 6/6 from a poor visual acuity of 6/60 or 6/36 after homoeopathic treatment.

Patients who have a history of recurrent attacks of uveitis are followed up on a long-term basis in spite of the fact that the acute exacerbation is rapidly controlled by the homoeopathic medicines. Such patients have not had a recurrence even 2 years after stopping treatment.

I have found that the average time taken for the inflammation in the eye to subside completely is about 5-6 weeks. The ophthalmic surgeon documents this improvement. All the inflammatory signs and exudates usually disappear within this period.

Patients with simple inflammation of the uveal tract, the so-called rheumatic iritis, usually had a clear vision within 2 weeks of beginning treatment.